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Solanezumab is a humanized monoclonal IgG1 antibody developed as a neuroprotector for Alzheimer's disease. It specifically binds to the mid-domain of soluble monomeric amyloid-beta (Aβ) peptide, not fibrillar forms, with high affinity. The mechanism of action involves sequestering soluble Aβ and facilitating its clearance from the brain by acting as an "amyloid beta sink," thereby shifting equilibrium and removing small toxic Aβ species that are implicated in synaptic dysfunction and neurotoxicity in Alzheimer's disease. Solanezumab was designed to slow progression of Alzheimer's by increasing peripheral elimination of amyloid beta, but large phase 3 clinical trials have not demonstrated significant clinical benefit in slowing cognitive decline in patients with mild-to-moderate or preclinical Alzheimer’s disease[1][3][4][5][7].
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